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Today 84% of the world’s population lives in developing countries where 93% of the world’s disease burden exists but only 11% of global health research dollars are spent.1 Although deaths in developing countries from communicable diseases such as tuberculosis (TB), malaria, and HIV/AIDS are slowly decreasing, the prevalence of noncommunicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease, and chronic respiratory disease are steadily rising. With the urbanization of towns and cities in developing countries, traffic crashes and injuries have become more common place. A high baseline prevalence of communicable diseases, along with rising rates of NCDs and injuries, will create inordinate future health system demands and may impede overall progress on the Millennium Development Goals (MDGs). Many of these diseases require surgical treatment to save lives, decrease suffering, and prevent or end disability to restore health and livelihoods. At present, access to complete surgical care in most developing countries is not readily available.

The Alma-Ata Declaration of 1978 identified primary health care as the cornerstone to achieving “health for all.” This historic document highlighted the gross inequities in health and access to care between people living in developed and developing countries. Although the Alma-Ata Declaration strongly supports primary care for all, it also “addresses the main health problems in the community, providing promotive, preventive, curative and rehabilitative services.” Appropriate, cost-effective curative and rehabilitative surgical interventions are secondary and tertiary preventive services and a necessary response to diseases that elude primary prevention.2

The volume of major surgeries performed worldwide is estimated to be between 187.2 million and 281.2 million procedures per year. A total of 73.6% of these surgeries occur in high-income countries and 22.9% in countries in transition, and only 3.5% take place in developing countries where most of the world’s population lives.3,4 The imbalance in the numbers of operations performed per capita in developed countries versus developing countries is due largely to the lack of available surgical care in these resource-challenged nations.

Definition of Surgery and International Surgical Care

The word surgery is an Anglicized derivation of the Latin word chirurgia, meaning “hand work.” A surgeon is any health provider who treats surgical conditions through manipulation of tissues and provides invasive measures such as incisions and ...